In a nutshell

The authors investigated the use of carboplatin instead of cisplatin in the DHAP chemotherapy regimen. The authors concluded that carboplatin is less toxic that cisplatin, and may be a good substitute.

Some background

Hodgkin lymphoma (HL) is generally considered a curable disease. However, some patients do not respond to first line treatment. DHAP (cisplatin, dexamethasone, and cytarabine) is a very common second line therapy. Cisplatin is very toxic to the body, especially the kidneys. Carboplatin has been considered as a replacement for cisplatin. It is unclear if carboplatin jeopardizes future stem cell transplantation. More research is needed on the side effects and effectiveness of carboplatin.

Methods & findings

This study looked at the effectiveness of DHAP (carboplatin, dexamethasone, and cytarabine) chemotherapy regimen for patients with Hodgkin’s and non-Hodgkin’s lymphoma. The medical records of 199 patients were reviewed. 26 patients had HL (13%). The rest of the patients had some form of non-Hodgkin’s lymphoma. The most common non-Hodgkin’s lymphomas were diffuse large B cell lymphoma (107 cases, 54%) and mantle cell lymphoma (26 cases, 13%). The average follow-up time for all patients was 2 years.

The overall survival rate at 2 years (time from treatment to death from any cause) was 89% for the whole group. 144 patients were scheduled to receive a stem cell transplant. 97% of those patients received their scheduled transplant.

The average progression free survival time (time from treatment to disease progression) for HL patients was 37 months. 69% of patients overall achieved a complete or partial response.

The bottom line

The study concluded that carboplatin may be a good substitute for cisplatin in the DHAP chemotherapy treatment, and is less toxic.

The fine print

The small sample size of patients with HL (26 patients) means that more research is needed.

Published By :

Annals of Hematology

Date :

Apr 03, 2017

Original Title :

Carboplatin instead of cisplatin in combination with dexamethasone, high-dose cytarabine with or without rituximab (DHAC+/-R) is an effective treatment with low toxicity in Hodgkin’s and non-Hodgkin’s lymphomas.